MEDICARE: PROLIFIC CARE HOMES 2 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1679429872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROLIFIC CARE HOMES 2 LLC

Provider Business Mailing Address
First Line	:	3909 W GOOD HOPE RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2334
Country	:	US
Telephone Number	:	262-613-0816
Fax Number	:	262-613-0816

Provider Business Practice Location Address
First Line	:	3909 W GOOD HOPE RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2334
Country	:	US
Telephone Number	:	262-613-0816
Fax Number	:	262-613-0816

Authorized Official
Title or Position	:	OWNER
Name	:	QUINTELA V MCNEAL
Credential	:
Telephone Number	:	262-613-0816

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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